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anatomy and physiology ii > Lesson 5 - Circulatory System: Blood > Flashcards

Lesson 5 - Circulatory System: Blood Flashcards

1
Q

the circulatory system consists of (3)

A
  1. the heart - muscular pump
  2. blood vessels - conducting system
  3. blood - fluid connective tissue medium
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2
Q

cardiovascular system

A

refers only to the heart and blood vessels

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3
Q

hematology

A

study of blood

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4
Q

fundamental purpose of the circulatory stsem

A

transport substances

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5
Q

blood

A

liquid transport medium

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6
Q

blood vessels ensure…

A

proper routing of blood

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7
Q

the heart is the…

A

pump that keeps blood flowing

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8
Q

three specific functions of the circulatory system

A
  1. transport
  2. protection
  3. regulation
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9
Q

functions of the circulatory system: transport

A

carry O2, CO2, nutrient, wastes, hormones, and stem cells

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10
Q

functions of the circulatory system: protection (5)

A

inflammation, limiting the spread of infection, destroy microorganisms and cancer cells , neutralize toxins, and initiate clotting

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11
Q

functions of the circulatory system: regulation (3)

A

fluid balance, stabilizes pH of ECF, and temperature control

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12
Q

blood consists of two parts

A

plasma and formed elements

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13
Q

plasma

A

matrix of blood; mostly water and has a clear, light, yellow appearance

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14
Q

formed elements (3)

A

erythrocytes, platelets, and leukocytes

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15
Q

erythrocytes

A

RBCs

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16
Q

platelets

A

fragments of certain bone marrow cells

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17
Q

leukocytes

A

WBCs

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18
Q

granulocytes (3)

A

neutrophils, eosinophils, basophils

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19
Q

agranulocytes (2)

A

lymphocytes, monocytes

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20
Q

five important functions of blood

A
  1. transportation of dissolved substances
  2. regulation of pH and ions
  3. restriction of fluid losses at injury sites
  4. defense against toxins and pathogens
  5. stabilization of body temperature
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21
Q

substances transported by blood: gases (2)

A

O2 and CO2

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22
Q

substances transported by blood: nutrients (3)

A

glucose, amino acids, fatty acids, etc.

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23
Q

substances transported by blood: hormones (3)

A

ACTH, TH, GH, etc.

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24
Q

substances transported by blood: immune system components

A

antibodies, etc

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25
Q

substances transported by blood: waste products

A

nitrogenous wastes

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26
Q

blood fractionation

A

separation of blood into basic components based on centrifugation and coagulation

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27
Q

which blood cells are the heaviest?

A

RBCs, they settle first

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28
Q

hematocrit (packed cell value)

A

total volume of whole blood that is RBCs, typically 45%

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29
Q

what do WBCs and platelets look like in a centrifuged vial of blood?

A

a narrow cream colored zone (buffy coat) that is less than 1% of total blood volume

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30
Q

where is plasma in a centrifuged vial of blood?

A

at the top of the tube and is usually about 55% of blood volume

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31
Q

blood serum

A

plasma without the clotting proteins (mainly fibrin) and calcium

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32
Q

plasma is a complex mixture of (7)

A

water, proteins, nutrients, electrolytes, nitrogenous wastes, hormones, and gases

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33
Q

what are the most abundant solute by weight?

A

plasma proteins

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34
Q

three major plasma protein categories

A

albumins, globulins, fibrinogen

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35
Q

the liver produces all of the major proteins except _____ _____ produced by plasma cells

A

gamma globulins

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36
Q

albumins

A

smallest and most abundant protein

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37
Q

what do albumins contribute to? (2)

A

viscosity and osmotic pressure

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38
Q

what do albumins do? (4)

what do they transport?

A

transport fatty acids, TH, steroid hormones, and buffer plasma pH

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39
Q

globulins (4)

what kinds?
h.m.a.i.

A

hormone-binding proteins, metalloproteins, apolipoproteins, immunoglobulins

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40
Q

what do globulins contribute to? (3)

A

roles in solute transport, clotting, and immunity

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41
Q

fibrinogen

A

soluble precursor of fibrin, a stick protein that forms the framework of a blood clot

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42
Q

where are most plasma proteins produced?

A

the liver

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43
Q

what does the remaining 1% of plasma proteins include?

A

changing amounts of proteins like peptide hormones and others secreted by the endocrine system

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44
Q

nitrogenous wastes

A

toxic end products of catabolism

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45
Q

urea

A

product of amino acids catabolism, the most abundant nitrogenous waste normally removed by the kidneys

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46
Q

the formed elements and plasma composition give rise to the _____ and _____ of blood

A

viscosity, osmolarity

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47
Q

what are the major contributors to blood viscosity? (2)

A

RBCs and albumin

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48
Q

osmolarity

A

total concentration of solute particles

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49
Q

how is optimum osmolarity achieved?

A

the body’s regulation of sodium ions, proteins, and RBCs

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50
Q

colloid osmotic pressure (COP)

A

contribution of protein on blood osmotic pressure; plays an important role in water balance

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51
Q

hypoproteinemia

A

deficiency of plasma proteins

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52
Q

what does hypoproteinemia cause? (4)

A
  • extreme starvation
  • liver of kidney disease
  • severe burns
  • tissues well, pool of fluid in the abdomen may accumulate
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53
Q

Kwashiorkor

A

children with severe protein deficiency

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53
Q

ascites

A

fluid accumulation in the abdomen

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54
Q

how do Kwashiorkor children develop?

A

they are fed on rice and cereals once they are no longer breast-fed leading to a protein deficiency in their diet

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55
Q

how can you identify a Kwashiorkor child?

A

thin arms and legs, and a swollen abdomen

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56
Q

hematopoiesis =

A

production of blood, especially formed elements

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57
Q

hematopoietic tissues produce

A

blood cells

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58
Q

the yolk sac produces what for a fetus?

A

stem cells for first blood cells that eventually colonize fetal bone marrow, liver, spleen, and thymus

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59
Q

the _____ stops producing blood cells at birth, but the _____ remains involved with lymphocyte production for life

A

liver, spleen

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60
Q

myeloid hematopoiesis

A

blood formation in the red bone marrow

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61
Q

lymphoid hematopoiesis

A

blood formation in the lymphoid organs; beyond infancy this only involved lymphocytes

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62
Q

hematopoietic stem cells (HSCs)

A

multipotent stem cells in the bone marrow that give rise to all formed elements

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63
Q

what do some HSCs go on to become?

A

specialized colony forming units (CFUs)

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64
Q

colony-forming units (CFUs)

A

destine to produce a specific class of formed element

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65
Q

structure of a RBC

A

disc-shaped cell that is biconcave; a thick rim and thin sunken cente

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66
Q

rouleaux

A

stacks of RBCs used to move through small blood vessels

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67
Q

how do RBCs produce ATP?

A

glycolysis/anaerobic fermentation
LACK MITOCHONDRIA

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68
Q

what does it entail that RBCs don’t have a nucleus or DNA?

A

they cannot synthesize protein or perform mitosis, so they only last about 120 befores being recycled by the body

69
Q

33% of RBC cytoplasm is _____

A

hemoglobin

70
Q

hemoglobin

A

functions in O2 and CO2 transport, and buffering of blood pH

71
Q

carbonic anhydrase (CAH)

A

produced carbonic acid from CO2 and water

72
Q

where is carbonic anhydrase?

A

RBC cytoplasm

73
Q

what role does carbonic anhydrase play?

A

important in CO2 transport and pH balance

74
Q

what determine a person’s blood type?

A

the glycolipids on the outer surface of mature RBCs

75
Q

what provides RBC membrane resilience and durability?

A

inner membrane surface has cytoskeletal proteins spectrin and actin that help RBCs stretch, bend, and fold

76
Q

hemoglobin structure (3)

A

two alpha chains and two beta chains each associated with a heme group

77
Q

what do 2.5% of adults have in place of their hemoglobin beta chains?

A

delta chains

78
Q

fetal hemoglobin has two _____ chains in place of beta chains

A

gamma

79
Q

how many molecules of oxygen can a heme group carry?

A

one

79
Q

how are fetal gamma chains different than adult beta chains?

A

they bind O2 more tightly than adult hemoglobin

80
Q

where does CO2 bind hemoglobin?

A

on the globin chains rather than the heme group

81
Q

heme

A

a nonprotein moiety that binds O2 with ferrous ion (Fe2+) at its center

82
Q

hematocrit is _____ proportional to body fat percentage

A

inversely

83
Q

why are hematocrit levels lower for women? (2)

A
  • androgens stimulate RBC production
  • females have periodic menstrual losses
84
Q

erythropoiesis

A

RBC production

85
Q

development of erythrocytes includes (4)

A
  • reduction in cell size
  • increase in cell number
  • synthesis of hemoglobin
  • loss of the nucleus
86
Q

when does erythrocyte production begin?

A

when hematopoietic stem cells become erythrocyte colony-forming units which have receptors of erythropoietin

87
Q

erythropoietin

A

stimulates colony-forming units to become an erythroblast

88
Q

where is erythropoietin made?

A

the kidneys

89
Q

erythroblasts multiple, synthesize hemoglobin, and after four days it becomes a _____

A

normoblast

90
Q

when the nucleus is discarded from the normoblast, the cell becomes a _____

A

reticulocyte

91
Q

what reticulocytes named for?

A

the fine network of polyribosomes

92
Q

when reticulocytes leave the bone marrow and enter the bloodstream, what happens?

A

polyribosomes disintegrate and the cell is then fully matured as an erythrocyte

93
Q

how it RBC count maintained?

A

negative feedback;

94
Q

what could happen if RBC count drops?

A

hypoxemia

95
Q

hypoxemia

A

oxygen deficiency in blood

96
Q

what happens when hypoxia is detected?

A

the kidneys increase EPO output, increasing RBC count in 3-4 days to reverse it

97
Q

causes of hypoxemia include (4)

A
  • blood loss/low RBC count
  • high altitude
  • increased exercise
  • loss of lung tissue in emphysema
98
Q

_____ is a key nutritional requirement for erythropoiesis

A

iron

99
Q

how is iron lost? (3)

A

urine, feces, and bleeding

100
Q

how is iron absorbed? (2)

A

by the small intestine into the blood where is binds transferrin for transport to bone marrow, liver, etc.

101
Q

bone marrow needs iron for _____

A

hemoglobin

102
Q

muscles need iron for _____

A

myoglobin

103
Q

all cells need iron to create…

A

cytochromes in mitochondria

104
Q

how is iron stored?

A

liver apoferritin binds iron to form the complex ferritin for storage

105
Q

additional nutrients required for erythropoiesis (4)

A

vitamin B12, folic acid, vitamin C, and copper

106
Q

why do we need vitamin B12 for erythropoiesis?

A

lack of it reduced stem cell division causing low RBC production (pernicious anemia)

107
Q

why do we need vitamin C and copper for erythropoiesis?

A

they are cofactors for enzymes synthesizing hemoglobin

108
Q

Iron Metabolism (8)

A
  1. mix of Fe2+/Fe3+ is ingested
  2. stomach acid converts Fe3+ to Fe2+
  3. Fe2+ binds gastroferritin
  4. gastroferritin transports it to small intestine and releases it for absorption
  5. in blood plasma, Fe2+ binds to transferrin
  6. in the liver, some transferring release iron for storage
  7. Fe2+ binds to apoferritin to be stores as ferritin
  8. remaining transferrin is distributed to other organs
109
Q

hemolysis

A

RBCs rupture in the narrow channels of the spleen and liver

110
Q

why do RBCs rupture in the spleen/liver?

A

their membranes become more fragile and less flexible

111
Q

what do macrophages do to digest ruptured RBCs?

A

they digest membrane bits to separate heme from globin

112
Q

what happens to globin during RBC digestion?

A

it is hydrolyzed into amino acids

113
Q

what happens to the heme group during RBC digestion?

A

the iron is removed from the heme pigment

114
Q

what happens to the heme pigment during RBC digestion?

A

it is converted into biliverdin (green)

115
Q

what happens to biliverdin during RBC digestion? (3)

A

it is converted into bilirubin (yellow-green) by the macrophage and is released into the blood, binding albumin

116
Q

what makes your urine yellow?

A

bilirubin

117
Q

what does the liver do with bilirubin? (2)

A

removes bilirubin from albumin and secretes into the bile

118
Q

bile pigments

A

collective term for biliverdin and bilirubin

119
Q

iron recycling

A

iron is removed heme to produce biliverdin

120
Q

what does iron bind to to be delivered to red bone marrow to synthesize new Hb?

A

transferrin

121
Q

what happens to excess trasnferrin?

A

transferred to storage proteins

122
Q

T/F: large quantities of free iron is not toxic to cells

A

false, it is

123
Q

primary polycythemia (2)

A

polycythemia vera
RBC excess due to cancer of erythropoietic line in bone marrow

124
Q

secondary polycythemia

A

polycythemia from all other causes, including dehydration, emphysema, high altitude, and physical condition

125
Q

dangers of polycythemia (2)

A
  • increased blood volume, pressure, and viscosity
  • can lead to embolism, stroke, heart failure
126
Q

anemia

A

deficiency of either RBCs or hemoglobin

127
Q

causes of anemia (5)

A
  • inadequate erythropoiesis or hemoglobin synthesis
  • nutritional deficiencies
  • kidney insufficiency
  • destruction of myeloid tissue
  • aging
128
Q

hemorrhagic anemia

A

anemia from bleeding; trauma and bleeding disorders

129
Q

hemolytic anemia (4)

A

from RBC destruction from drug reactions, poisoning, infections, hereditary defects, blood type incompatibilities

130
Q

iron-deficiency anemia

A

lack of iron uptake/metabolism that affects RBC production

131
Q

what is excessive iron uptake linked to?

A

heart disease

132
Q

inadequate erythropoiesis anemias (2)

A

iron-deficiency and pernicious

133
Q

pernicious anemia (2)

A

autoimmune attack of stomach tissues that leads to inadequate intrinsic factor production, which is needed of rB12 absorption

134
Q

hypoplastic anemia

A

decline in erythropoiesis

135
Q

aplastic anemia

A

complete cessation of erythropoiesis; failure or destruction of myeloid tissue

136
Q

three potential consequences of anemia

A
  1. tissue hypoxia
  2. reduced blood osmolarity producing tissue edema
  3. low blood viscosity
137
Q

effects of tissue hypoxia (3)

A
  • patient is lethargic
  • shortness of breath upon exertion
  • life threatening necrosis of the brain, heart, or kidney
138
Q

what happens with low blood viscosity? (2)

A
  • heart races and pressure drops
  • cardiac failure may ensue
139
Q

sickle-cell disease

A

a hereditary hemoglobin defect

140
Q

who is sick-cell disease most commonly found in? (4)

A

people of sub-Saharan Africa, Mediterranean basin, Middle East, and Indian descent

141
Q

is sickle-cell recessive or dominant?

A

recessive

142
Q

how does sickle-cell hemoglobin (HbS) differ from normal Hb?

A

only on the sixth amino acid of the beta chain

143
Q

what is special about sickle-cell heterozygotes?

A

the are resistant to malaria

144
Q

what can sickle-cell disease lead to? (5)

A
  • kidney or heart failure
  • stroke
  • joint pain
  • paralysis
145
Q

how do HbS red blood cells behave different? (2)

A
  • they become rigid, sticky, and pointed at the ends
  • the agglutinate and block small blood vessels
146
Q

how well does HbS bind O2?

A

not well

147
Q

antigens

A

complex molecules on surface of cell membranes

148
Q

antigens include (3)

A

proteins, glycoproteins, glycolipids

149
Q

how are antigens useful?

A

they are used to distinguish self from foreign matter, foreign matter generates an immune response

150
Q

agglutinogens

A

antigens on the surface of the RBC that triggers agglutination (clumping)

151
Q

antibodies

A

proteins that bind to antigens to mark them for destructions

152
Q

agglutination

A

antibodies bind multiple foreign cells and sticks them together, large clumps may result

153
Q

agglutinins

A

antibodies that bind algutinogens

154
Q

RBC antigens (2)

A

agglutinogens
glycolipids on RBC surface

155
Q

blood type A has what antigen? (2)

A

antigen A/anti-B

156
Q

blood type B has what antigen? (2)

A

antigen B/anti-A

157
Q

blood type AB has what antigen? (2)

A

both A and B antigens/no anti-antigens

158
Q

blood type O has what antigen? (2)

A

neither A or B/anti-A and anti-B

159
Q

a mismatch during a blood transfusion causes a _____ _____

A

trasnfusion reaction

160
Q

transfusion reaction (2)

A

(1) agglutinated RBCs block small blood vessels, hemolyze, and release their hemoglobin over hours/days (2) where hemoglobin blocks kidney tubes and causes acute renal failure

161
Q

Charles Drew

A

first black person to pursue an advanced degree in medicine to study transfusion and blood banking

162
Q

what special thing did Charles Drew do?

A

used plasma rather than whole blood, which caused less transfusion reactions

163
Q

Rh blood group

A

includes numerous antigens like C, D, and E

164
Q

which Rh antigen is the most reactive?

A

antigen D

165
Q

what antigen makes a person Rh+?

A

antigen D

166
Q

are anti-D antibodies normally present?

A

no, they only form in Rh- individuals exposed to RH+ blood

167
Q

will an Rh- female with and Rh+ fetus or transfusion of Rh+ blood cause any problems?

A

no; they do not naturally have anti-D antibodies

168
Q

hemolytic disease of the newborn (HDN)

A

erythroblastosis fetalis
may occur when a woman has a baby with mismatched blood type

169
Q

What causes hemolytic disease of the newborn?

A

if an Rh- mother has more than one Rh+ child, the anti-D antibodies formed during the first pregnancy can cross the placenta and agglutinate fetal RBCs, cause hemolysis, and result in the baby having severe anemia

170
Q

how do you prevent hemolytic disease of the newborn?

A

Rh immune globulin (RhoGAM) is given during the 28 to 32 weeks gestation and during birth to prevent the mother from forming anti-D antibodies

anatomy and physiology ii (19 decks)

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